Publication: International Journal of Antimicrobial Agents
Abstract
Antibiotic dosing during continuous renal replacement therapy is particularly challenging, and polymyxin B pharmacokinetics during continuous venovenous haemofiltration (CVVH) had not been well characterized. This study in 53 patients receiving CVVH and polymyxin B for multi-drug-resistant Gram-negative infections built a population pharmacokinetic model using Phoenix NLME, comparing drug exposure during and outside CVVH sessions. CVVH significantly increased polymyxin B clearance, reducing steady-state AUC nearly three-fold compared with periods off CVVH, and Monte Carlo simulations indicated a 200 mg loading dose plus 150 mg every 12 hours would best achieve target exposure during CVVH. The findings support higher polymyxin B doses with therapeutic drug monitoring for patients undergoing CVVH to maintain adequate efficacy.
Author(s): Wang P, Xing H, Zhang F, Liu S, Lu Y, Zhang X, Yang J, Sun T
Published: 2022 年 5 月 5 日
Phoenix NLME：Dosing Through Renal Replacement Therapy
Phoenix NLME's population model showed continuous venovenous haemofiltration nearly triples polymyxin B clearance in this study, prompting a higher recommended dose. Phoenix NLME is also available through RsNLME, bringing population PK/PD modeling into R for teams who prefer that environment, within a Phoenix platform relied on by more than 11,000 users worldwide.
